Public Release: 21-Sep-2006
A better diet through online shopping?

Advice provided while internet shopping can help people buy healthier food

We all know that people should eat less saturated fat, but it can be hard to achieve changes in behaviour. Rachel Huxley and colleagues from the George Institute for International Health in Sydney, Australia, wanted to find out whether dietary advice delivered through an internet shopping system could help people make healthier food choices. They conducted a randomized trial, offering participants using an internet shopping system the chance to receive either general dietary advice (the trial's control) or tailored advice which prompted shoppers to replace items with alternatives lower in saturated fat. The researchers found that participants receiving tailored advice bought foods containing less saturated fat, on average, than the participants only getting general advice. These results show that low-cost technologies delivered through the internet have the potential to motivate users to change their behaviour. Rachel Huxley, from The George Institute of International Health and one of the authors of the study, says: "The great thing about this result is that it represents a simple, low cost step that food retailers could make now. We will be contacting each of the major Internet shopping operators in Australia to find out their interest in working with us to turn this research into reality. We hope that by publishing the article in an open access journal like PLoS the results will reach the maximum possible number of people, worldwide."

The results are published in PLoS Clinical Trials, an open-access journal that aims to increase the reporting of clinical trials. Steve Nissen, from the Cleveland Clinic, Ohio, USA, and a member of the editorial board of PLoS Clinical Trials, says: "I applaud the commitment of PLoS Clinical Trials to provide open access to randomized clinical trial reports so that investigators throughout the world can freely examine the results of these studies."

Children who get severe malaria in Africa are at a high risk of dying in hospital even though there are effective treatments. Some evidence suggests that lowered blood fluid volume is a factor in determining the outcome in these children. However, very few trials have been done that examine the best way of rehydrating children that are in shock from severe malaria, or what type of fluid should be used. In this trial, performed by a researcher from Imperial College, London Dr. Kathryn Maitland and her colleagues at The KEMRI-Wellcome Trust Research unit, Kilifi, Kenya, 88 children presenting with severe malaria were given either albumin solution or gelofusine, through an intravenous line. Although the trial didn't show any major differences in the ability of the different types of fluid to resolve shock, the research group found a lower mortality rate in the group receiving albumin.

Dr Kathryn Maitland explains: "The observation that treating very sick children with severe malaria with albumin infusion can reduce the mortality rate by over 80% represent a major breakthrough towards improved treatment of this devastating illness. However, administration of fluid to children critically ill with severe malaria is contrary to prevailing practice and therefore it is absolutely essential that we are certain that the results are true before we advise on any change in practice.

The results of this trial support have gone some way to answering the question of whether this sort of supportive treatment saves lives and we are now seeking funding to set-up a larger trial involving over 1,000 children in Ghana, Gambia and Kenya to confirm these findings."

Nick Day comments in an accompanying perspective: "Given that severe malaria is such an important disease in terms of morbidity and mortality throughout the tropical world, it is astonishing how few clinical trials have addressed its treatment... Akech and colleagues are to be congratulated for pursuing practical clinical answers to how the management of severe malaria in Africa can be improved."

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All works published in PLoS Clinical Trials are open access. Everything is immediately available without cost to anyone, anywhere--to read, download, redistribute, include in databases, and otherwise use--subject only to the condition that the original authorship is properly attributed. Copyright is retained by the authors. The Public Library of Science uses the Creative Commons Attribution License.

About PLoS Clinical Trials

PLoS Clinical Trials is an open access, freely available international medical journal. The journal's goal is to broaden the scope of clinical trials reporting by peer-reviewing and publishing the results of all randomized trials that are ethically and scientifically sound, irrespective of the trial's outcome. PLoS Clinical Trials aims to increase the accuracy and completeness of the evidence base for clinical decision-making. For more information see http://www.plosclinicaltrials.org.

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit http://www.plos.org.

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